Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance

Latest Earnings Reports Show State of Health Payers in 2017

August 7, 2017 - At the half-year mark, payers have a good sense of how well their efforts to promote value-based care have fared and the opportunity to make the necessary adjusts where they have not. As part of the business-facing side of value-based care, payers must stand out through effective marketing, extensive consumer choice, transparent pricing, consumer growth and retention, and other methods that...


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Effective Steps for Health Insurance Marketing, Consumer Engagement

by Thomas Beaton

Creating and deploying effective health insurance marketing and consumer engagement plans can be difficult for payers in today’s complex purchasing landscape.   Payers must focus on building strong brands, clear messaging, and effective...

How Can Health Savings Accounts Help, Hinder Patients and Payers?

by Thomas Beaton

Health savings accounts (HSAs) have been widely discussed as lawmakers consider policy reforms, at the federal level, and have become a fixture in conversations about healthcare spending among payers and patients alike.   HSAs are consumer...

What to Look for in Health Insurance Enrollment Technology

by Thomas Beaton

Health insurance enrollment technology is designed to offer payers convenience, cost savings, and administrative ease-of-mind when it comes managing beneficiaries enrolled in health plans. Many Americans face challenges when seeking new health...

AHA to CMS: Continue Funding ACA Cost-Sharing Reductions

by Thomas Beaton

CMS should continue to fund the cost-sharing reductions (CSRs) that keep the Affordable Care Act insurance marketplaces relatively stable, the American Hospital Association (AHA) said in a comment letter. AHA asserts that should the government...

BCBS of Louisiana Offers Online Consumer Price Comparison Portal

by Thomas Beaton

In an effort to improve transparency and customer engagement, Blue Cross Blue Shield (BCBS) of Louisiana launched an online consumer price comparison portal. The portal, called SmartShopper, allows any BCBS  customer in Louisiana to compare...

Member Engagement for Payers Should Focus on Simplicity

by Jesse Migneault

For payers, an effective member engagement strategy can lead to better member health, lower claims cost, and improved product loyalty.  To achieve these goals, payers should start by identifying pain points and implementing processes that...

Narrow Insurance Networks Can Limit Options for Cancer Care

by Jesse Migneault

Cancer patients may have limited access to top-tier healthcare options if enrolled in narrow insurance networks, according to a study from the Perelman School of Medicine at the University of Pennsylvania.  Policymakers and payers have a...

Kaiser Permanente Health Plan Falls Short on Behavioral Health

by Jesse Migneault

Kaiser Permanente’s health plan does not adequately ensure that patients can access behavioral health services in a timely and effective manner, says the California Department of Managed Health Care after a routine survey.  The report...

Healthcare Payers See Promise in Private Exchange Successes

by Jesse Migneault

Private exchanges have grown in significance as a means for payers to get their products before employers, and their growth has resulted in increasing the number of health plan options for employees and beneficiaries. Additionally, the expanded...

Employees Like Wellness Programs, But Don’t Use Them Much

by Jesse Migneault

As employers and payers move towards a more engaged preventive health environment, the use of workplace wellness programs have increased across the nation, according to results from a UnitedHealthcare Consumer Sentiment Survey. Today, nearly...

4 Ways Payers Can Stay Competitive with Medicare Advantage Plans

by Jesse Migneault

With an aging population and soaring healthcare costs, the public interest in Medicare Advantage (MA) plans has been steadily increasing.   As the marketplace becomes crowded with plan options and insurers, payers must understand how...

Retail Clinics Offer Member Satisfaction, Savings for Payers

by Jesse Migneault

At a time when many individual private and employer-based health plans include higher deductibles, retail clinics are becoming a popular option for beneficiaries seeking high quality care at a lower price point. Payer partnerships with these...

Employers See Consumer Directed Healthcare as the Future

by Jesse Migneault

With the continuing rise in healthcare costs, employers are looking to alternatives such as CDH plans to cut premium costs and increase employee's’ financial responsibility for their healthcare spending.  CDHs are an employer health...

AMA, AHA Call for Stronger Patient Insurance Protections

by Jesse Migneault

The American Medical Association (AMA) has joined seven prominent health industry groups in calling for the Senate to address patient protection concerns regarding health insurance coverage.  The move by eight of the nation’s leading...

Cigna, CVS MinuteClinics Partner for Expanded Healthcare Access

by Jesse Migneault

Cigna and CVS Health have partnered to launch Cigna Health Works for expanded healthcare access for the payers employer-based health plan members.  The launch is currently limited to certain markets only. Cigna Health Works will align members...

Employer Health Plans See Spike In Out-of-Pocket Costs

by Jesse Migneault

The National Center for Health Statistics study found a double-digit increase in the use of high-deductible employer health plans has generated increased economic strain for members. Beneficiaries reported struggling to pay medical bills or delaying...

ACA Medicaid Expansion Boosted Care Access, Patient Outcomes

by Jesse Migneault

Low-income adults taking advantage of the Affordable Care Act’s Medicaid expansion experience more financial stability and better outcomes, according to a new study from the Harvard T. H. Chan School of Public Health. “Our four years...

$18M Claimant Case Challenges Affordable Care Act Payers

by Jesse Migneault

In April of 2017, Wellmark Blue Cross Blue Shield, which operates in Iowa and South Dakota, announced it would exit the 2018 health insurance exchanges.  The payer cited higher than expected claims costs, including Member X, who had claims...

Healthcare Costs Vary Widely Across Geographic Regions

by Jesse Migneault

New research from the Health Care Cost Institute (HCCI) shows that healthcare costs for three common procedures, including knee injections, ACL repairs, and knee replacements, varied greatly across 61 metro areas.   The results...

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